A Systematic Review and Meta-Analysis of Systemic Corticosteroids for the Palliation of Dyspnea in Patients with Cancer

Kozue SUZUKI; Hideki KATAYAMA; Hiroyuki KOHARA; Yoshinobu MATSUDA; Sho GOYA; Jun KAKO; Yoko KASAHARA; Masanori MORI; Takeo NAKAYAMA; Hiroaki WATANABE; Takashi YAMAGUCHI

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A Systematic Review and Meta-Analysis of Systemic Corticosteroids for the Palliation of Dyspnea in Patients with Cancer

VernacularTitle:がん患者の呼吸困難に対するコルチコステロイド全身投与の有効性：システマティックレビュー・メタ解析
Author: Kozue SUZUKI ¹ ; Hideki KATAYAMA ² ; Hiroyuki KOHARA ³ ; Yoshinobu MATSUDA ⁴ ; Sho GOYA ⁵ ; Jun KAKO ⁶ ; Yoko KASAHARA ⁷ ; Masanori MORI ⁸ ; Takeo NAKAYAMA ⁹ ; Hiroaki WATANABE ¹⁰ ; Takashi YAMAGUCHI ¹¹
Author Information

1. Department of Palliative Care, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital
2. Palliative and Supportive Medicine, Okayama University Hospital
3. Department of Palliative Care, JCHO Tokuyama Central Hospital
4. Department of Psychosomatic Internal Medicine, NHO Kinki-Chuo Chest Medical Center
5. Department of Respiratory Medicine, Kinki Central Hospital
6. Graduate School of Medicine, Mie University
7. Regional Medical Cooperation Room, Akimoto Clinic
8. Division of Palliative and Supportive Care, Seirei Mikatahara General Hospital
9. Department of Health Informatics, Kyoto University School of Public Health
10. Home Palliative Care Asunaro Clinic
11. Department of Palliative Medicine, Kobe University Graduate School of Medicine
Keywords: systemic corticosteroids; dyspnea; patients with cancer
From:Palliative Care Research 2025;20(2):95-102
CountryJapan
Language:ja
Abstract: Objective: Almost half of all patients with cancer experience dyspnea, which can have various causes. Although systemic corticosteroids are administered to relieve symptoms, their efficacy has not been established. This systematic review aims to determine the efficacy of systemic corticosteroids for dyspnea in patients with cancer. Methods: CENTRAL, MEDLINE, EMBASE, and Ichushi-Web databases were searched for articles published from their inception to September 23, 2019, on studies of systemic corticosteroid administration for dyspnea in patients with cancer. The primary outcome measure was dyspnea intensity, as assessed by patient-reported outcomes. Secondary outcome measures were quality of life, delirium, and severe adverse events. Results: Two RCTs were included in the meta-analysis. With regard to alleviating dyspnea, the systematic corticosteroid group was associated with significantly greater dyspnea relief than the placebo group (mean difference: −0.71 [95% CI: −1.4 to −0.03]). However, a meta-analysis of quality of life and delirium could not be performed due to insufficient data. Analysis of severe adverse events showed no significant difference in their incidence between the corticosteroid and control groups (relative rate: 0.96 [95% CI: 0.19-4.93]). Conclusions: Systemic corticosteroids may be effective in treating dyspnea in patients with cancer, particularly those with lung involvement. Limiting the conditions for which corticosteroids are approved is expected to promote their appropriate use and minimize their adverse effects. However, further investigation is needed to determine the appropriate dosage, and the conditions in which corticosteroids are effective.